Some dentists are overcharging NHS patients by hundreds of pounds a time, an undercover investigation has found.
They are quoting patients up to £725 for work which should cost just £198, under the current three tiered payment system for NHS work.

They are also commonly neglecting to offer patients a scale and polish alongside a check-up, which should both be covered under the lowest tier of work, and are instead trying to sell it as a private add-on.

Dentists should provide NHS patients with all the treatment that is “clinically necessary in order to keep your mouth, teeth and gums healthy”, according to a Department of Health leaflet.

Patients should pay a single charge depending on the complexity of the work, even if more than one procedure needs to be carried out.

The leaflet makes clear: “If your dentist says that you need a particular type of treatment, you should not be asked to pay for it privately.”

However, an undercover reporter for Channel 4′s Dispatches programme, who needed root canal work and a new crown, was mis-quoted by three dentists he went to see.

Under current NHS rules, they should have said both procedures were covered under Band 3 pricing, costing the patient a single charge of £198.

But one quoted him £725 for both pieces of work; the second said the crown was covered by the £198 NHS fee, but that the root canal work would cost him £480 as a private piece of work; while the third gave a similar quote, saying the root canal work would cost £400.

Seven more undercover patients went for check ups at different dentists. None of them was offered a scale and polish as part of NHS treatment, although they all needed one, even though this should be included under Band 1 treatment, which at the time carried a £16.50 charge.

Three of them were told they could opt to see a hygienist privately, a service typically costing £25 to £40.

Dentists say the way the banding system works pushes them towards wrongly charging extra for treatment – known as ‘gaming’.

Danny Pretorius, who stopped doing NHS work last year, told the programme: “If you had to do everything by the book like you should do, it would be virtually impossible to earn a reasonable living.”

The current “payment by procedure” system, which was introduced by Labour in 2006, has been very unpopular with dentists.

Last December the Coalition announced it was to be abolished and replaced with a “payment by patient” system, to encourage more preventive work.

Pilots of three variants of the new scheme are due to start around the country this summer.

A Department of Health spokesman said: “We are committed to improving dental access, and we will achieve this sustainably by replacing the existing dental contract with one that pays dentists for the number of patients registered and the quality of the care they provide, rather than the number of treatments carried out.”

*Dispatches: The Truth About Your Dentist was broadcast on Channel 4 at 8pm last night (Monday).

Councils are planning a sharp rise in care home fees to counter Government cuts and a rapidly aging population.
Almost nine out of 10 local authorities confirmed proposals to charge more for residential accommodation to plug a huge budget shortfall, figures show.

Other councils are planning to shut centres altogether or dramatically tighten up the eligibility for places over coming years.

The disclosure will fuel warnings over a crisis in care for the elderly.

It follows warnings last year that growing numbers of pensioners are being forced to sell their homes to cover expensive care home fees amid spiralling costs.

Emily Thornberry, the shadow care services minister, who obtained the latest figures, said the Government was failing to protect social care. Miss Thornberry’s office surveyed 50 councils providing care services.

Almost all said they were being forced to make sweeping changes to residential accommodation because of a combination of cuts and increasing pressure on services.

Some 88 per cent confirmed plans to increase care charges. A quarter of these were pegging increases to inflation, but others were introducing new and additional charges, raising or abolishing the maximum contribution from users or making other increases.

Almost two-thirds of councils said they were being forced to close care homes or day centres to save money.

Many confirmed plans to close homes in the next two years, while others said money was being saved by putting more emphasis on providing services in residents’ own homes.

A previous survey carried out by the Care and Support Alliance, whose members including more than 40 leading charities, has found that 23 per cent of disabled and older people have already seen their services cut.

Many said they can no longer afford essentials such as food and heating as a result of having to pay for care, while more than half said their health had suffered after support was reduced.

Paul Burstow, Minister of State for Care Services, said: “Under Labour social care was always the poor relation. Under the Coalition social care is receiving a £2bn spending boost including an unprecedented transfer of funds from the NHS to support integration.

“In 13 years Labour failed to reform the way we fund social care. Labour’s survey results are the product of that failure. Without the Coalition’s decision to priorities social care Labour’s legacy of underfunding would have been even greater.

“We are determined to put in place a lasting and fair settlement to the funding question. This Government has acted quickly to set up the Dilnot Commission on funding.”

From: http://www.telegraph.co.uk/health/Councils-planning-sharp-rise-in-care-home-fees

New EU red tape has come into force banning hundreds of traditional herbal remedies.
The EU red tape which kicked in on May 1st is claimed to protect consumers from possible damaging side-effects of over-the-counter herbal medicines.

For the first time, new regulations will allow only long-established and quality-controlled medicines to be sold.

But both herbal remedy practitioners and manufacturers fear they could be forced out of business.

To date, the industry has been covered by the 1968 Medicines Act, drawn up when only a handful of herbal remedies were available and the number of herbal practitioners was very small.

But surveys show that about a quarter of all adults in the UK have used a herbal medicine in the past two years, mostly bought over the counter in health food shops and pharmacies.

The regulations will cover widely used products such as echinacea, St John’s Wort and valerian, as well as traditional Chinese and Indian medicines.

But safety concerns have focused on the powerful effects of some herbal remedies, as well as the way they interact with conventional drugs.

For example, St John’s Wort can interfere with the contraceptive pill, while ginkgo and ginseng are known to have a similar effect to the blood-thinning drug warfarin.

From now on only products that have been assessed by the Medicine and Healthcare products Regulatory Agency (MHRA) will be allowed to go on sale.

Manufacturers will have to prove that their products have been made to strict standards and contain a consistent and clearly marked dose.

And to count as a traditional medicine, products must have been in use for the past 30 years, including 15 years within the EU.

They will also only be approved for minor ailments like coughs and colds, muscular aches and pains, or sleep problems.

The manufacturers of herbal remedies have had seven years to prepare for the new rules after the European Directive on Traditional Herbal Medicinal Products was introduced in 2004.

These regulations apply to over-the-counter sales, which form the bulk of herbal remedies sold in the UK.

But some manufacturers and herbal practitioners have expressed concern, arguing the new rules are too onerous for many small producers.

Michael McIntyre, chairman of the European Herbal and Traditional Medicines Practitioners Association, says there will be a significant impact on herbal medicine practitioners and their suppliers, but admits the rules do need bringing up to date.

“Products that go on the market now will definitely do what it says on the bottle, while we didn’t know how good they were in the past.

“But registration is expensive so perhaps there may be fewer products on the market and a smaller range.

“It’s difficult to argue that the market should stay as it is, without any regulation, but how many businesses will pack up and walk away? I can’t say.”

A Department of Health spokesperson said: “We have swiftly introduced a system to register herbal practitioners using unlicensed herbal medicines, so consumers will be able to continue to use unlicensed herbal medicines if they wish.”

The emergence of antibiotic resistant infections has reached unprecedented levels and now outstrips our ability to fight it with existing drugs, European health experts are warning.
Each year in the EU over 25,000 people die of bacterial infections that are able to outsmart even the newest antibiotics.

The World Health Organization says the situation has reached a critical point.

A united push to make new drugs is urgently needed, it says.

Without a concerted effort, people could be dealing with the “nightmare scenario” of worldwide spread of untreatable infections, says the WHO.

One example is the New Delhi or NDM-1 superbug recently found in UK patients. They have brought the infection back with them from countries like India and Pakistan, where they had visited for medical treatment and cosmetic surgery.

The Cardiff University researchers, who made the discovery last August, now say bacteria with this new genetic resistance to antibiotics have contaminated New Delhi’s drinking water supply, meaning millions of people there could be carriers.

Dr Timothy Walsh and his team collected 171 swabs of seepage water and 50 public tap water samples from sites within a 12km radius of central New Delhi between September and October 2010.

The NDM-1 gene was found in two of the 50 drinking-water samples and 51 of 171 seepage samples.

Worryingly, the gene had spread to bacteria that cause dysentery and cholera, which can be easily passed from person to person via sewage-contaminated drinking water.

“Oral-faecal transmission of bacteria is a problem worldwide, but its potential risk varies with the standards of sanitation.

“In India, this transmission represents a serious problem… 650 million citizens do not have access to a flush toilet and even more probably do not have access to clean water,” the researchers warn in the journal Lancet Infectious Diseases.

The scientists are calling for urgent action by health authorities worldwide to tackle the new strains and prevent their global spread.

Zsuzsanna Jakab, WHO regional director for Europe, said: “Antibiotics are a precious discovery, but we take them for granted, overuse and misuse them: there are now superbugs that do not respond to any drugs.

“Given the growth of travel and trade in Europe and across the world, people should be aware that until all countries tackle this, no country alone can be safe.”

The UK’s Health Protection Agency said it was monitoring the spread of NDM-1 closely.

“The first case of a bacterial infection with this resistance was identified in January 2008. Monitoring of this resistance began in 2009 as more cases were identified.”

So far, there have been around 70 cases of the infection recorded in the UK.

The HPA insists that the risk of infection to travellers to the Indian subcontinent who are not treated in hospital is minimal.

“If members of the public are travelling for surgery overseas they should satisfy themselves that appropriate infection control measures are in place,” says the HPA.

From: http://www.bbc.co.uk/news/health-12975693

The cost of NHS dentistry is prompting some patients to delay treatment or opt for cheaper care, a survey suggests.
The NHS Information Centre poll of more than 11,000 people in England, Wales and Northern Ireland found a fifth had put off treatment over price.

The Adult Dental Health Survey, which is carried out every decade, also found a quarter said cost influenced the kind of treatment they opted for.

NHS dental care is subsidised, but patients still pay towards their care.

There are three price bands ranging form £16.50 for a basic check-up to £198 for complex procedures, including crowns.

Pregnant women, those on low incomes and children are exempt from paying.

As well as highlighting cost, more than one in 10 said extreme anxiety deterred them from the dentists, while a fifth cited dissatisfaction with previous treatments.

Of those surveyed, 58% said they had tried to make an NHS dental appointment over the past three years, of which 92% were successful. However, that does not mean the rest did not have dental treatment as some would have paid for private care.

From: http://www.bbc.co.uk/news/health-12849853

The government is putting in place measures to prevent the National Health Service from becoming an international health service, and is undertaking a wider review of current practice in charging non-residents for care to create a fairer system.
Following consultations last year on a package of proposals on charging visitors for NHS hospital care, the government has decided to instill tougher measures in a bid to tackle health tourism, a practice by which some patients come to the UK to access healthcare without paying, costing the country millions of pounds every year.

One such measure involves preventing anyone owing the health service £1,000 or more from staying or entering the UK until their debt is paid off, and as such the NHS will be expected to pass details of foreign patients who have failed to pay for treatment on to the UK Border Control Agency.

According to the government, this action alone should capture 94% of outstanding charges owed to the health service.

In other changes for NHS patients in England, the time UK residents can stay abroad and keep their entitlement to free hospital treatment has been extended from three to five months.

In addition, the small number of failed asylum seekers co-operating on registered Home Office support schemes will be exempt from charges, while all unaccompanied children under local authority care will also be guaranteed free hospital treatment.

However, the government feels that the existing system is still too complex, generous and inconsistently applied, and so has launched a wider review of practice.

This, it says, will look at changing the residency criteria for treatment, whether GPs should and other ex-hospital services should charge non-residents, and whether visas should be dependent on health insurance, in order to ensure that the system is both fair and affordable.

According to health minister Anne Milton, the changes will “begin the process of developing a clearer, robust and fairer system of access to free NHS services which our review of the charging system will complete”, with the aim of creating a system that “maintains the confidence of the public while preventing inappropriate free access and continuing our commitment to human rights and protecting vulnerable groups”.

From: http://www.pharmatimes.com/Government_cracks_down_on_health_tourism

Private hospitals bucked the recession in 2009 – but only by massively expanding the amount of work they carry out for the National Health Service, according to the analysts Laing and Buisson.Overall, revenue rose by 7.5 per cent to £3.76bn. But patients treated under private medical insurance fell by 30,000 between 2007 and 2009 as the recession hit. The numbers paying out of their own pocket dropped further – down by almost 45,000.

However, work for NHS patients, who now have the right to go to any private hospital willing to treat them at the NHS price for waiting-list type treatments, rocketed.

Their numbers almost quadrupled between 2007 and 2009, up from 55,900 to 212,000, so that NHS patients made up almost 22 per cent of private hospital cases, up from 6.3 per cent in 2007.

The result was a rise in independent hospital activity, with about 975,000 patients treated, against 888,000 in 2007.

Some NHS patients are sent by NHS hospitals to keep waiting times down.

But the numbers exercising their right to choose are rising sharply – running at a rate of 200,000 procedures a year in July this year, according to Laing’s Healthcare Market Review, the bible on private sector activity. That is business worth £400m a year.

William Laing of the review said senior health department officials believe patient choice activity in the private sector could triple. His own estimate is that it might ultimately rise five fold to about £2bn a year – although that would still be less than 20 per cent of NHS waiting list activity.

“Expanding the services they provide for the NHS has obvious attractions for independent hospitals because the publicly paid market is massively greater than the traditional private healthcare market.

“But it has great dangers as well, since too much focus on publicly paid patients could compromise their appeal to traditional, privately paying customers. There is a conflict which independent hospital providers have not yet fully resolved.”

If the independent sector seriously wanted to address the potentially huge public market, he said, it would “have to grow a lot more capacity”.

That could come from a mix of the existing players and new hospital providers entering the market with lower cost business models that generate reasonable profits from the prices that the NHS is prepared to pay.

The figures came on the day the Office of Fair Trading launched a wide ranging review into the private healthcare market – among other issues examining the barrier to new entrants joining it.

From: http://www.ft.com/cms/s/0/675afcb4-07b7-11e0-a568-00144feabdc0,s01=1.html#axzz18ALgaS00

An investigation into how well the private healthcare market is working is being planned by the Office of Fair Trading (OFT).
It will examine the nature of competition in the market, as well as whether it is fully competitive.

The OFT said its preliminary research had raised questions about whether the market was working well for private patients.

It aims to formally launch its investigation in spring next year.

Meantime, it is seeking views on the proposed scope of the study.

The OFT says the private healthcare market is worth £5.5bn and is of growing importance due to an ageing population, improved medical outcomes and higher life expectancy.

It added that it was of growing importance to the NHS because of government initiatives that allow NHS patients to seek treatment from private healthcare providers in certain circumstances.

Sonya Branch, OFT senior director of services and public markets said: “We are keen to focus on whether patients and buyers of private healthcare, including the NHS, are getting the full benefit of choice and competition.”

She added that as the area was a complex one, the OFT would be speaking to providers, patients and government to make sure that it focussed on the correct issues.

Bringing more competition to the NHS under White Paper reforms would be “potentially damaging” the British Medical Association (BMA) argues.A market-led approach “creates waste, bureaucracy and inefficiency”, Dr Hamish Meldrum, chairman of council at the BMA, said.

Under proposals put forward in July by Andrew Lansley, the Health Secretary, GPs are to be given the power to manage £80 billion of the NHS budget to buy care from hospitals and other doctors, while tiers of management are to be axed.

The BMA said today- Friday, that while it was “interested” in these proposals, the greater efficiencies they could bring might be undermined by more private sector involvement.

Dr Meldrum said: “There are proposals in the White Paper that doctors can support and want to work with. But there is also much that would be potentially damaging.

“The BMA has consistently argued that clinicians should have more autonomy to shape services for patients, but pitting them against each other in a market-based system creates waste, bureaucracy and inefficiency.”

Dr Meldrum said that while he was “not ideologically against markets” he did not believe the evidence showed they had worked in the NHS so far.

Private finance initiatives and privately-run treatment centres, which sold their services to the NHS, resulted in taxpayers’ money leaving the service, he said.

“The private sector is not doing this out of some great social generosity, they want to make a profit,” he argued.

He was talking as the BMA submitted its response to the White Paper: Equity and Excellence: Liberating the NHS.

From: http://www.telegraph.co.uk/BMA-says-White-Paper-reforms-potentially-damaging

Ministers are considering ‘privatising’ an NHS agency that provides 50,000 nurses and other workers to the health service.
An advert has been placed for private sector investment in NHS Professionals, a company owned by the Department of Health, which provides bank staff to fill shifts in the health service.

Unions criticised the plan saying it was privatisation and that NHS Professionals was set up to stop the NHS being ripped off by private agencies charging large sums for staff to work unfilled shifts.

NHS Professionals has 50,000 staff on its books who cover around two million shifts in 77 organisations around England.

Karen Jennings, head of health at Unison, said: “The whole reason that NHS Professionals was set up, was because private agencies were ripping off hospitals by charging them outrageous fees for recruiting or finding staff for shifts. It makes no sense at all to bring back private companies who will want their slice of the action in return.

“This proposal is purely about Tory plans to promote privatisation and hive off parts of the NHS to private companies, regardless of the consequences on patient care.”

A Department of Health spokesman said: “This is about exploring ways that the commercial skills of the independent sector can make NHS Professionals Ltd a more efficient business and save the NHS money.

“NHS Professionals Ltd is a business, not a public service, and like any business it must ensure its services are as efficient and effective as possible. We want to discuss options with potential independent sector investors that could help to achieve this, and ultimately improve services outcomes for patients.”

It comes as the Royal Berkshire Hospital Trust announced up to 600 jobs will be cut to make £60 million worth of savings in the next few years, pledging that frontline staff would not be affected.

The Royal College of Nursing said last month that thousands of NHS jobs were being cut despite Government promises to protect frontline services.

The nurses’ group said it was aware of almost 10,000 posts lost through recruitment freezes, redundancies and people not replaced when they retired, or which face cuts in the future.

From http://www.telegraph.co.uk/Ministers-accused-of-privatising-NHS-nursing-agency